•
A scheme that gives the Office of Personal Management immense power in
administering what amounts to a multi-state public plan;• How much a state “opt-out” of abortion
coverage in the legislation erodes the long-standing Hyde-amendment;• The budgetary impact of ELIMINATING the physician
reimbursement fix; and,• Multiple new taxes, federal regulations and sweet-heart
deals aimed at certain states like Nebraska.

That’s
if all goes according to plan, and it may not be a completely done deal.
Reid claims to have the 60 votes needed since Nebraska Senator Ben Nelson
– long a holdout – gave his nod of approval and thanks, having
been offered a deal for the federal government to pay Nebraska’s
share of an expansion of Medicaid.

But
reportedly there are still four Democrats, perhaps others, who have not
announced that they will vote for cloture, though they could be balanced
out by a few liberal Republicans who could decide to vote yes.

Winners
and Losers

Dennis
Smith, analyst at Heritage Foundation reports
that in Reid’s amendment Hawaii, Massachusetts, Nebraska and Vermont
are clear winners, granted special favors in time for Christmas at the
expense of other states. The amendment expands Medicaid eligibility and
inserts State Children’s Health Insurance Plan (SCHIP) rules into
the exchange.

According
to Smith: “While all the other states will lose the extra federal
financing for new Medicaid eligibles after 2017, full federal financing
will continue for Nebraska. Hawaii gets funding for Disproportionate Share
Hospital (DSH) payments that it gave up years ago to expand Medicaid eligibility.
Ironically, $18.5 billion in cuts to the DSH program in all the other
states help finance the rest of the health care legislation.”

Since
Massachusetts and Vermont have already expanded Medicaid eligibility,
they would not benefit from new federal financing under the original legislation.
But the Reid amendment will substitute federal funds for state funds.

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“Who
are the losers?” asks Smith -- All the other states.

“According
to the Congressional Budget Office (CBO) analysis
of the Reid amendment, total state funding for Medicaid and SCHIP
will increase by $1 billion compared to the original legislation. Clearly
if total state spending goes up and spending for a few favorite states
goes down, then all the other states are picking up the tab.”

CBO’s
“Mirage”

The
CBO analysis plays a significant roll in the ongoing Senate debate. Indeed,
Reid would not release his amendment until the CBO had looked it over
and passed judgment, which was that the amended Reid plan would reduce
the federal budget deficit by $132 billion over the period 2010 to 2019.”

Heritage
Foundation’s James Carpetta calls such a conclusion a “mirage”
and the bill itself a “budget buster.”

“As
CBO notes, the bill presumes that Medicare fees for physician services
will get cut by more than 20 percent in 2011, and then stay at the reduced
level indefinitely,” writes
Carpetta. “There is strong bipartisan opposition to such cuts.
Fixing that problem alone will cost more than $200 billion over a decade,
pushing the Reid plan from the black and into a deep red.

Peter
Sepp, Vice President of Communications for the National
Taxpayers Union, told NewsWithViews a Congressional Budget Office
report "lends a cloak of legitimacy" to legislation. CBO scores
are not mandatory, but can be requested by the sponsor and Reid had said
that any health care bills and amendments would need a CBO score.

Sepp
said the CBO is “scrupulous” in its work, “but part
of the problem is that these bills are written in a way that the CBO can
make only certain assumptions about their impacts and provisions. If you
proscribe certain limits on how the bill will operate, well of course
it’s going to get a good CBO score. You can make assumptions inside
the bill that are completely unrealistic and stupid, but the CBO can’t
say that. They can only say: ‘Based on the projections in this bill
we believe the cost will be X.’”

Melt
the Phone Lines

Last
week, in a Conservative Call to
Action, on Breitbart.tv, Rep. Michele Bachmann (R-Minn.) called on
Americans to “melt the phone lines” of their representatives
in Congress. She was talking about a just-discovered stealth bill, then-pending
in the House, on the federal take-over of the financial services sector
of the economy – but urged similar action on the other major bills,
such as Reid’s health care measure, and to keep the pressure up
all week by phoning their offices every day.

Bachman
asked: “Is it too much to ask your listeners to pick up the phone
Monday through Friday and call their congressmen and senators
and say ‘No, you cannot have the government do this’? Is it
too much to drive to their district office and take five of your friends
with you and ask for a meeting with one of the staff there? Those are
the actions that will kill these bills!”

Organizing
for America and other leftwing organizations are doing just that,
though for the opposite reason. They have phone banks set up so their
activists can contact Senate offices and perhaps get through to the senators
themselves during the debate because they know how important this item
is to their agenda.

Conservative
groups, too, are urging their members and allies to keep those email and
faxes and phone calls pouring in for entire debate – and make those
phone calls. And it does work, says Bachmann.

If the
schedule goes as expected, the final bill on health care will be Christmas
Eve. But as NewsWithViews reported,
there is a possibility the action won’t stop there.

Sepp
suggested that it would not be surprising if Reid called House Speaker
Nancy Pelosi on the phone as soon as the cloture vote is completed Monday
morning and saying: “Look. We’ve done all the heavy lifting;
it’s just a matter of another day or two until we get it passed,
so you better make plans to call your people back.

“[The
House] might be there ready and waiting for the passage vote literally
an hour after the Senate does its job on Wednesday [or whenever the final
vote takes place].”

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Sepp
also worried that while a number of both Republicans and Democrats just
want to spend Christmas with their families, “there are a lot of
Democrats who will do anything to get this through. So the momentum may
be with them if this goes so late into next week.”

Sepp
suggested that it would not be surprising if Reid called House Speaker
Nancy Pelosi on the phone as soon as the cloture vote is completed Monday
morning and saying: “Look. We’ve done all the heavy lifting;
it’s just a matter of another day or two until we get it passed,
so you better make plans to call your people back.